Inspirational Beginnings in an Occupational Therapy Mental Health Setting

SUMMARY

This article includes excerpts from a fieldwork log for a student's Level I experience. The student was assigned to the Brooklyn Veteran's Administration Medical Center Inpatient and Day Hospital Program with an occupational therapist supervisor. It recounts the student's concerns, in a beginning placement, as an individual who had no previous exposure to a mentally ill population. In the course of understanding the role of occupational therapy with the benefit of a strong clinician role model, the student not only learns procedural skills in occupational therapy assessment and group leadership, but also engages in a reflective process of professional growth and begins to develop a more conditional and holistic perspective of the patients with whom she is working towards fine-tuning critical aspects of the therapeutic use of self. Through the use of a learning contract developed in the format of a Goal Attainment Scale (GAS), she formulates a goal for the psychomotor domain of improving skills in interpersonal relationships with patients focusing on using verbal and nonverbal communication for interaction in a     

Occupational Therapy Shared Decision Making in Adolescent Mental Health

Shared decision making (SDM) shares values of client-centered practice; however, a few studies exist that explore experiences of occupational therapists (OTs) working in adolescent mental health. This study aims to better understand SDM in adolescent mental health using the Canadian Model of Client-Centered Enablement. A qualitative study included interviews (n = 6) and analysis using an inductive approach. The role of the OT, client factors, therapeutic relationship, and nature of the decision were identified as influencing the process and outcome of SDM. The study helps better understand SDM in practice, the need for specialized education for OTs and has identified future research areas.     

Principles of Occupational Therapy Group Outcome Assessment in Mental Health

In today's penurious health care climate, occupational therapists must scrutinize their practice and substantiate their interventions in order to remain viable service providers. This article proposes a method of occupational therapy outcomes assessment in mental health care that is rooted in client-centered functional outcomes. Since little consensus exists on which instruments are most effective, this article begins with an outline of broadly accepted principles for assessment of patient outcomes in mental health. Next, we describe a practical method for selecting outcomes measures in interdisciplinary settings. Finally, we offer pragmatic solutions to address barriers to outcome assessment.     

A Bibliometric Analysis of the Quantitative Mental Health Literature in Occupational Therapy

ABSTRACT

A bibliometric analysis was performed to examine the impact and use of the peer-reviewed occupational therapy intervention effectiveness literature addressing adults with mental illness, 2000–2016. Of 2,597 articles, 68 were quantitative studies assessing an intervention for adults with mental illness. These studies had a collective citation count of 1,455 and were published in 29 journals in 14 countries. The majority (n?=?36; 52.94%) were randomized controlled and two-group controlled studies. The most commonly assessed interventions were life skills and community reintegration (n?=?20, 29.41%) and supported employment (n?=?16, 23.52%). Sixty-five (95.58%) studies found statistically significant results on the primary or secondary outcomes.     

Occupational Therapy Student Experiences and Transformations During Fieldwork in Mental Health Settings

The purpose of this study is to better understand the transformative experiences of occupational therapy students during fieldwork. In occupational therapy education, fieldwork provides students with an in-depth experience in the field. Thirty-one students submitted narratives following completion of Level II fieldwork in a mental health setting. Concepts from transformative learning theory guided the analysis. The themes that emerged were: (1) understanding clients with mental illness; (2) understanding occupation and occupational therapy; (3) feeling like a professional; and (4) changing as a person. The results highlight the importance of understanding the transformative process and fieldwork in mental health settings.     

Effectiveness of Dialectical Behavior Therapy in a Community Mental Health Center

Dialectical behavior therapy (DBT) has been shown to be effective in randomized controlled trials with women with borderline personality disorder and histories of chronic self-inflicted injury including suicide attempts. The present study is a pre-post replication of a comprehensive DBT program in a community mental health center for individuals who chronically injure themselves and/or have experienced multiple treatment failures. Twenty-four subjects were given the Treatment History Interview to obtain information regarding medically treated self-inflicted injuries and the use of crisis services. After 1 year of treatment, DBT showed a significant reduction in the number and severity of self-inflicted injuries, psychiatric-related emergency room visits, psychiatric inpatient admissions and days, and the number of crisis treatment systems engaged. Results are compared to benchmarks from 3 other clinical trials of DBT. While this pre-post comparison has threats to internal validity, it supports the feasibility of DBT when fully implemented in a community mental health clinic.     

Family Therapy Training for Paraprofessionals in a Community Mental Health Center

An ecologically oriented family therapy training program is advocated for teaching paraprofessionals to work with high-risk clients in a community mental health setting. The context of training as well as the particular abilities and needs of beginning paraprofessional family therapists are explored in order to design a flexible and effective program in the face of limited resources. This paper describes a variety of educational and supervisory formats such as group supervision, peer supervision, and live supervision. The usefulness of these different models in facilitating skill development and growth in paraprofessionals is evaluated. Recommendations are made to trainers concerning problems encountered in teaching paraprofessionals and in implementing family systems training in community mental health centers.     

Latina Mothers' Perceptions of Mental Health and Mental Health Promotion

Latina mothers' perceptions of mental health and factors that promote/restore mental health were explored in this qualitative study. Participants discussed the importance of community, safety, and financial stability in addition to conventional factors that are related to mental health. Implications for working with urban Latinas and their families are discussed. En este estudio cualitativo se exploraron las percepciones de las madres Latinas sobre Salud Mental y los factores que la fomentan/restablecen. Las participantes discutieron acerca de la importancia de la comunidad, la seguridad y la estabilidad financiera además de otros factores convencionales relacionados con la salud mental. Se discuten las implicaciones para el trabajo con Latinas residentes en núcleos urbanos y sus familias.     

Occupational Therapy Interventions in Mental Health: A Literature Review in Search of Evidence

A growing body of literature sheds light on occupational therapy (OT) interventions and outcomes in adult mental health. Although this research has not developed to the point where a systematic review is warranted, a synthesis of these findings is needed. This article provides an overview of OT interventions in adult mental health and their documented outcomes. Fifty peer-reviewed intervention studies targeting adults with mental illness were reviewed. Seven categories of interventions emerged: employment/education; psychoeducation; creative occupations/activity; time use/occupational balance; skills/habit development; group/family approaches; and animal-assisted therapy. Further research involving rigorous designs is needed to establish a solid evidence base for OT interventions in adult mental health.     

Assessing Mental Health Providers' Perceptions of Consumer-Providers

To gain insight into the challenges of the occupational role of consumer-provider, the authors describe a program evaluation that assessed mental health providers' perceptions of consumer-providers. A qualitative research design was used to assess non-consumer providers' attitudes toward and perceptions of consumer-providers, perceptions of the quality of services consumer-providers deliver, and knowledge and awareness of consumer-providers' education and training background. Four themes emerged, including: (1) service delivery, (2) comparisons between consumer-provided and non-consumer staff provided services, (3) perception and opinion of consumer-providers' education and training background, and (4) power dynamics. Implications of the findings are discussed.     

Perceptions of Spirituality and Spiritual Care in Occupational Therapy Practice

Occupational therapists view human occupation as active engagement in that which brings meaning to the life of the patient. Spirituality is understood to be one important construct in the creation of meaning in the lives of human beings. This study examined the attitudes toward the use of spiritual care in occupational therapy. The study sample consisted of 310 occupational therapists. Data were collected through the use of a secure web-based survey tool. Analysis was conducted to determine the significance of relationships between several important constructs (e.g., education, theory base, definition of spirituality) and perceptions regarding the use of spiritual care.     

The Evidence Base for Occupational Therapy in Mental Health: More Systematic Reviews Are Needed

To shape its work, the Research Centre for Occupation & Mental Health is interested in research priorities. Systematic reviews develop an overview of the research available about an intervention, which can provide evidence to underpin practice. They also however, identify gaps in the knowledge base and so are useful for research-prioritization exercises. A rigorous literature search identified only four systematic reviews about occupational therapy in mental health, which suggests that more are needed to underpin practice. This article also explains a six-stage process for conducting a systematic review that can be used by occupational therapists in mental health.     

An Integrative Review of School-Based Mental Health Interventions for Elementary Students: Implications for Occupational Therapy

Occupational therapy for children and youth experiencing mental health conditions is often overlooked in current school-based services, as the traditional role within the system is often limited to physical health issues. The purpose of this integrative review is to investigate current psychosocial interventions within school settings to understand the effects of services provided and to determine potential roles for school-based occupational therapists. The findings of this review support occupational therapists in facilitating interventions that target mental health in school settings. Psychotherapy presented the strongest evidence for reducing psychosocial symptoms in school settings.     

Citizenship and Community Mental Health Care

Citizenship is an approach to supporting the social inclusion and participation in society of people with mental illnesses. It is receiving greater attention in community mental health discourse and literature in parallel with increased awareness of social determinants of health and concern over the continued marginalization of persons with mental illness in the United States. In this article, we review the definition and principles of our citizenship framework with attention to social participation and access to resources as well as rights and responsibilities that society confers on its members. We then discuss our citizenship research at both individual and social‐environmental levels, including previous, current, and planned efforts. We also discuss the role of community psychology and psychologists in advancing citizenship and other themes relevant to a citizenship perspective on mental health care and persons with mental illness.